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General Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Rebecca Fish, Aisling Hogan, Aoife Lowery, Frank McDermott, Chelliah R Selvasekar, Choon Sheong Seow, Vishal G Shelat, Paul Sutton, Yew-Wei Tan, Thomas Tsang
What if the semen analysis showed a volume of 3 mL, five motile sperm per high-power field?This could be a case of failure or due to a low number of ejaculations to clear the reproductive tract.I would warn the patient of failure and the possible need for a repeat vasectomy if a subsequent sample confirms motile sperm (1:17000 men have a double vas).
Phagocytosis By Human Neutrophils
Published in Hans H. Gadebusch, Phagocytes and Cellular Immunity, 2020
Perhaps the greatest stimulus to investigation of chemotaxis came with the development of the Boyden chamber.96 The original device consists simply of an upper and lower chamber separated by a millipore filter of known pore size (usually 3 m). Since the diameter of the neutrophil is considerably greater than this (6 to 8 m), the cells will have little tendency to migrate through the filter unless there is a stimulus to do so. The lower chamber is filled with a putative chemotactic factor, the upper with a suspension of isolated cells, and the entire apparatus is incubated at 37°C for several hours. During this incubation period, the chemotactic substance diffuses up through the filter and establishes a concentration gradient. The cells follow the gradient and migrate through the pores of the filter to the underside where they remain attached. The filter is removed, fixed, and stained. The underside of the filter is examined by light microscopy and the average number of cells per high power field determined. The random migration of the cells may be determined in the same system by substituting the medium in which the cells are suspended for the chemotactic substance in the lower chamber.
Semen Analysis
Published in Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh, Male Infertility in Reproductive Medicine, 2019
Meaghanne K. Caraballo, Alyssa M. Giroski, Rakesh Sharma, Ashok Agarwal
Round cells in the semen sample consist of immature germ cells and leukocytes. The presence of excessive immature germ cells in the ejaculate may indicate an environment of oxidative stress (OS) during spermatogenesis [6]. Therefore, it is important to differentiate between these two round cells. To distinguish between the two, round cells are counted in a high-power field. Presence of more than 5 round cells or >1 × 106 round cells on the wet prep indicates testing for presence of white blood cells according to WHO guidelines. Presence of <1.0 × 106 round cells may contain activated leukocytes, which can produce the ROS that are harmful for the spermatozoa [7,8].
The effect of povidone-iodine rectal cleansing on post-biopsy infectious complications
Published in Scandinavian Journal of Urology, 2023
In group 2, no patient was hospitalized for infectious complications. All patients were phoned and asked for complications, but three patients (1.5%) did not readmit to the hospital for routine control 7–10 days after the biopsy since they declared that they had no complaints on a phone call. The remaining 188 patients were closely followed up, and no other doctor gave them any medication. Hematuria lasting 1–2 days was the most common complaint of group 2 patients. Nearly half of the patients, 89 patients (46.5%), answered that they had hematuria, 38 patients (19.8%) complained of hematospermia, 34 patients (17.8%) complained of dysuria. Only five out of 34 patients who complained about dysuria had leucocyturia on urine analysis. There was no bacterial growth on the urine cultures of these 34 patients. Thirty patients complained of rectal bleeding (15.7%). No patient complained of fever. Three patients (1.5%) were readmitted to the hospital for acute urinary retention the next day after the biopsy. On urine analysis, 62 patients (32.9%) had only microscopic hematuria (5 or more red blood cells per high-power field), and 21 patients (11.1%) had both microscopic hematuria and leucocyturia (5 or more white blood cells per high-power field).
Lactic acid, citric acid, and potassium bitartrate non-hormonal prescription vaginal pH modulator (VPM) gel for the prevention of pregnancy
Published in Expert Review of Clinical Pharmacology, 2022
To provide effective vaginal contraception, a product would have to cause 100% sperm immobilization. VPM has a dose-dependent effect on sperm immobilization activity and acidification. In an in vitro study, with a volume ratio of 1:2 VPM to human semen, the sperm immobilization rate was 100% and the vaginal pH was 4.56. However, in a clinical study, post-coital testing showed 0.07–0.75 PMS/hpf despite a gel dose of 5 gm (~5 mL). With typical semen volumes of 2–5 mL, the ratio of VPM to semen volume would be at least 1:1, and up to 2:1, which should have resulted in 0 PMS/hpf based on in vitro testing. This discrepancy between in vitro testing with 100% immobilization and in vivo post coital testing with progressively motile sperm visualized has also been seen with N-9. In vitro or controlled preclinical testing of N-9 that provided 100% sperm immobilization or 0 PMS/hpf have resulted in 0.0–0.5 PMS/hpf in clinical post-coital testing, with a subsequent contraceptive study resulting in a 13.5% failure rate of N-9 [68,69]. This is likely due in part to inconsistent mixing of a gel that is adherent to the vaginal walls as well as due to leakage of product before, during, and after intercourse. Both of which could result in lower final ratios of gel to semen, and because of the dose-dependent effect, could result in higher failure rates.
Genetic and shared environmental risk factors do not lead to eosinophil activation in healthy twins of IBD patients
Published in Scandinavian Journal of Gastroenterology, 2020
Jonas Halfvarson, Maria Ling Lundström, Maria Lampinen, Ida Schoultz, Lennart Bodin, Marie Carlson
Immunohistochemical analyses for quantification of activated eosinophils were performed on biopsies from rectum in the group of twins earlier defined. From the biopsies that were formalin-fixed and embedded in wax, sections were cut and mounted on clean glass slides. Slides were then deparaffinized in xylene, rehydrated through decreasing concentrations of alcohol and finally rinsed in TBS Auto Wash Buffer (pH 7,6) (Biocare Medical, Concord, CA, USA). A monoclonal antibody to EPO (generous gift from Professor Per Venge, University of Uppsala, Sweden) was used to identify eosinophil granulocytes. Sections were incubated with the antibody overnight at room temperature in a humid chamber. The antigen-antibody complex was visualized by enzymatic reaction using a commercial HRP-polymer kit (MACH-1 Universal HRP-polymer kit, Biocare Medical, Concord, CA, USA) according to the protocol achieved from the manufacturer. The sections were mounted with Pertex (HistoLab Products AB, Västra Frölunda, Sweden). Ten high power fields (hpf) on each section were examined by two individuals in a blinded manner using a Leica DRMB microscope (x320) and EPO stained cells were counted. If the number of cells differed >3 standard deviations, they were counted a third time by another independent individual.